The Delaware Health Information Network and the Oregon Health Authority each received $625,000, the Rhode Island Quality Institute received $489,544, and the Utah Health Information Network got $624,604.

The Delaware HIN serves 60 hospitals in Delaware and Maryland, and will use its grant—it's third from the ONC—to connect with counterpart HIEs in New Jersey and southeastern Pennsylvania, said Randy Farmer, its COO.

That will enable Delaware hospitals to send and receive patient admission, discharge and transfer (ADT) notifications with other healthcare providers.

Salt Lake City-based UHIN will use its money to create a more robust provider directory, enhance its patient portal capabilities and expand its ability to send hospital ADT notices to healthcare organizations in Idaho, Nevada and Wyoming.

Linking state and local HIEs to create a nationwide "network of networks" has been a federal goal since the George W. Bush administration founded the ONC in 2004.

But the feds' HIE program has seen both winners and losers, according to an independent report released earlier this year by the research agency NORC at the University of Chicago.

The number of acute care hospitals able to “push” an electronic message to another provider's EHR increased nearly tenfold from just over 100 hospitals in 2011—when the ONC exchange grants were first awarded—to just under 1,000 in 2013, according to the NORC report.

Acute-care hospitals capable of more advanced “query-based” information exchanges increased from fewer than 400 in 2011 to 2,000 by 2013, the research group said.

But HIE leaders also expressed concerns about their organizations' long-term financial viability, NORC researchers found, while seven of the 56 original participants in the ONC's HIE grant program have already gone belly up, according to the report.